Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Country Villa South Bay, LLC

Organization Skilled Nursing Facility · NPI 1104810159

Country Villa South Bay, LLC is a Skilled Nursing Facility in Van Nuys, California. Licensed in California. Registered with an NPI since 2005.

Licensed in
CA
In the registry since
2005
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

13524 Sherman Way
Van Nuys, CA 91405-2830
Phone: (818) 786-3470
Fax: (818) 786-0943
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X (CA)

Record details

NPI number1104810159
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephen Reissman — Trustee Of Managing Member · (310) 574-3733
Other names Country Villa Woodman Healthcare Center
NPI enumeratedSeptember 6, 2005
Last updated in NPPESAugust 22, 2020
Mailing address5120 W Goldleaf Cir, Suite 400, Los Angeles, CA 90056-1292

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